Individual
DR. ROBERT MARCUS MOEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.O1/
Contact information
Practice address
1710 S MAIN ST, WEST BEND, WI 53095-4938
(262) 334-7077
(262) 338-3505
Mailing address
5154 S 18TH AVE, WEST BEND, WI 53095-9281
(262) 677-3979
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1823
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38577100
—
WI
Enumeration date
05/19/2006
Last updated
07/09/2007
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